INTRODUCTIONThe purpose of this paper is to demonstrate the application of an Oriental Medicine approach to psychotherapy* in clinical practice. This case study of substance abuse and depression is a good example of a single acupuncture treatment applied in confluence with specific psychotherapeutic counselling, yielding successful results. This case is then placed in the context of: 1) current research on acupuncture as a treatment for substance abuse and depression and 2) the current status of mental health service in Australia.

The paper concludes by 1) questioning the research methodology which is crucial to formulating public and professional perception of the value of Oriental Medicine in the treatment of mental health disorders; and 2) underscoring the value of psychotherapy in confluence with acupuncture treatment.

* “Psychotherapy: The treatment of mental and emotional disorders through the use of psychological techniques designed to encourage communication of conflicts and insight into problems, with the goal being relief of symptoms, changes in behaviour leading to improved social and vocational functioning, and personality growth.” The American Heritage Dictionary of the English Language, Fourth Edition

CASE HISTORY
Tom, 27 year old male, musician/teacher.
Presenting Complaint
Tom was struggling to overcome an long term pattern of prolific, daily smoking of marijuana. He had smoked marijuana for eleven years and had been a heavy user for the past seven years.
Pr
Associated Problems
Depression, pessimism and melancholy; loss of motivation; suicidal thoughts; poor memory and concentration; fatigue; cold hands and feet; red facial rash. P ulse
The general pulse quality was flooding, slippery and slightly rapid. In the Spleen and Lung positions the pulse was swelling at the superficial levels, but lacked intrinsic strength. Tongue
Swollen tongue body with red sides and tip; thin phlegmy coat Abdomen
Tender in the lower lateral abdomen and along the Kidney channel. General Health
Good; fit and active. Tom appeared to have a bright and cheery personality. History
Family Histor y
Tom’s father was diagnosed with depression. His grandmother had exhibited signs of depression. Several of Tom’s extended family have been regular marijuana smokers. Treatment
Previous Medical Diagnosis or Treatment
None.

Aetiology and Pathogenesis
PathogenesisThe dominant signs in this case are of excess: Stagnation of Qi and Blood, Liver and Heart Fire and accumulation of Phlegm. But underlying all of these is a pattern of Spleen Qi deficiency. This is demonstrated by the swollen tongue with the thin, phlegmy coat. The Spleen Qi deficiency has led directly to an accumulation of Phlegm and a Stagnation of Qi and Blood in the lower abdomen, the presence of which further weakens Spleen. The long term drug use has damaged Yin, leading to Empty Heat, compounded by the actual inhalation of heat, regarded as Exogenous Pathogenic Fire. This Heat has affected the Liver and Heart and combined with Phlegm to disrupt Heart Shen, hence the depression and melancholy.

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